EVALUATION OF HBV DNA LEVELS IN SALIVA IN SUBJECTS WITH DIFFERENT VIREMIA AS WELL AS DURING PEGINTERFERON α-2a THERAPY.

Hepatitis B virus is the most important infectious hazard in dental profession. Vectors of HBV infection are not only blood, but also saliva, nasopharyngeal secretions, crevicular fluid.The aim of the study was to evaluate serum and salivary HBV DNA levels in subjects with chronic infection and dynamics of HBV levels during the first 3 months of peginterferon α-2a therapy to be determined. Nineteen parallel samples were tested for HBV DNA by real-time PCR assay. All nineteen sera were positive for HBV DNA with levels ranging from 494 to 6 300 000 000 cp/ml. HBV DNA was detected in all saliva samples even in patients with very low viremia. HBV DNA levels in serum and saliva were quite similar in cases with serum HBV DNA < 10 000 cp/ml. Patients with viremia higher than 10 000 cp/ml had significantly lower HBV DNA levels in saliva.The presence of HBV DNA in saliva might not be only due to transudation or exudation of fluid containing virus from the general circulation into various body fluids. These facts clearly demonstrate the role of saliva in routes of HBV transmission. Our results confirm the possibility of dentist’s particiation in infection transmission and suggests that salivary analysis holds promise as a non-invasive approach to identify biomarkers for diseases

Creació d'una xarxa virtual utilitzant un VPS com a intermediari

[ES] En este trabajo se tratará la creación, configuración y securización de un servidor privado virtual (VPS) con una dirección IP pública asignada para dar lugar a una red virtual para comunicar los distintos dispositivos remotos que se conecten a él. Con esto permitiremos la conexión de distintos dispositivos móviles a redes domésticas o redes de empresa. Las conexiones a este servidor se harán a través de VPN para ofrecer una conexión segura y se instalará un servidor RADIUS para la autenticación de los usuarios que se conecten a la VPN.[EN] This work will deal with the creation, configuration and securing of a virtual private server (VPS) with a public IP address assigned to create a virtual network to communicate the different remote devices that connect to it. With this we will allow the connection of different mobile devices to home networks or company networks. Connections to this server will be made through VPN to offer a secure connection and a RADIUS server will be installed to authenticate users who connect to the VPN.Antonov Valev, K. (2022). Creación de una red virtual usando un VPS como intermediario. Universitat Politècnica de València. http://hdl.handle.net/10251/185815TFG

PREDICTORS OF SUSTAINED VIROLOGICAL RESPONSE (SVR) TO PEGYLATED INTERFERON ALPHA (PEG-IFN α) AND RIBAVIRIN (RBV) IN PATIENTS WITH CHRONIC HEPATITIS C INFECTED WITH GENOTYPE 1.

Objective: The combined PEG-IFN alpha and RBV therapy achieved SVR in 40 - 50% of patients infected with HCV genotype 1. Identification of virological and host paramemeters predicting SVR will be useful to tailor therapy. Methods: 71 patients with chronic HCV genotype 1 infection were treated with PEG-IFN alpha2a and RBV for 12 months. Predictors of SVR were analyzed by using nonparametric correlation test. Results: SVR was found in 57 / 71 of subjects (80,3%). The significant differences in baseline level of HCV RNA, sex, age, baseline ALT and present of liver cirrhosis between the patients with or without SVR were not found. Correlation was not proved between SVR and all these factors when they were analyzed separately. High correlation was found between serum levels of HCV RNA at the end of 3-th month therapy (Early Virological Response) and SVR (r=0,759; p=0,011).Conclusion: The viral response during the first 3 months of PEG-IFN alpha and RBV therapy is the strongest independent predictor among the all baseline viral and host predictive factors for achieving of SVR

PREDICTORS OF SUSTAINED RESPONSE TO INTERFERON-BASED THERAPY IN CHRONIC HEPATITIS B

Objective: IFN-based therapy induces long-term remission in ~20% of CHB-patients. Identification of predictors of treatment response can facilitate the clinical decision. Methods: 168 CHB-patients treated with IFN-based therapy were studied. Predictors of end-of-treatment response (ETR) and sustained response (SR) one-year post therapy were identified by non-parametric chi-square test and correlation analysis. Results: Low baseline HBV DNA (4xULN) were independent predictors of ETR. Low viral load was stronger predictor than high ALT level. If both factors coexist the probability of ETR was 92%. In HBeAg-negative subjects SR correlates significantly with age below 40 years, evidence of early viral response at 3rd month, fibrosis stage F<3 (METAVIR) and prolongation of treatment duration. HBeAg-seroconversion up to 6-month post-therapy was the strongest predictor of SR in HBeAg-positive patients.Conclusion: More favorable results could be achieved by pretreatment selection according to patients’ age, baseline viral load, ALT and liver fibrosis. Extension of IFN-treatment in responders may enhance the SR rate

Outcome in a patient with systemic lupus erythematosus and concurrent chronic hepatitis B infection

A 35-year-old Caucasian woman with proven systemic lupus erythematosus (SLE) had been effectively managed with hydroxychloroquine and methylprednisolone for many years. In 2005 she was admitted to the rheumatology clinic with a flare up of the disease and with proteinuria of 3.2 g/24 h. Renal biopsy was performed and revealed diffuse proliferative nephritis. Before the renal biopsy a positive HBsAg was found with high virus replication (hepatitis B virus (HBV)-DNA—4 170 000 copies/ml). Liver biopsy revealed chronic hepatitis with minimal activity (TAIS=1). Lamivudine was administered with concomitant maintenance corticosteroid treatment, but without antimalarials. Pulsed methylprednisolone treatment for diffuse lupus nephritis was begun on the background of lamivudine therapy. The liver enzymes returned to normal values, HBV replication was suppressed, and the proteinuria disappeared. At present the patient is not being treated with lamivudine and there are no objective signs of nephritis and hepatitis, or HBV activation

THE CYTOKINE IP-10 IN CHRONIC HBV AND HCV INFECTION

Introduction: IP-10 it has been studied as a predictor of treatment response in chronic HCV infected patients. The data for the HBV infection are not enough.Aim: To compare IP-10 levels in patients with chronic HBV /CHB/ and HCV infection /CHC/ and their relation to liver disease and treatment response. Material and methods: 20 patients - with CHC genotype 1 infection /on standard bi-therapy/ and 32 patients with CHB /21 pts - NUC; 11 pts - IFN/. Results: The IP-10 did not correlate with sex, age, ALT and liver fibrosis. The basal IP-10 were lower in patients with CHB (p=0,017). There was a difference in IP-10 baseline levels among the HCV patients with or without RVR (p=0,007). A negative correlation was found between basal IP-10 and RVR (r= -0,508; p=0,008). Conclusion: IP-10 could predict virological response in patients with CHC on standard bi-therapy, but not in HBV infected patients on standard therapy

METABOLIC FACE OF CHRONIC HEPATITIS B AND C IN BULGARIA

It is well known that NAFLD, as well as diabetes mellitus (DM), correlated with the progression of liver fibrosis in chronic hepatitis C (CHC). The impact of NAFLD overlap in chronic hepatitis B (CHB) is not well established. Aim. In this study we compared the prevalence of NAFLD and related metabolic parameters in CHC and CHB, and their relationship with disease activity and fibrosis. Methods. The parameters of metabolic syndrome (MetS), glucose, insulin, HOMA-IR and histological features of steatosis / steatohepatitis were investigated in total of 700 patients with chronic viral hepatitis - CHB (n=334) and genotype 1 CHC (n=366). Glucose and insulin were also assessed during OGTT (60 and 120 min.) in 100 cases with CHB and 100 – with CHC. Results. Nonalcoholic metabolic related steatosis was more frequent (62% v/s 48%) and severe in CHC compared to CHB (p<0.01). MetS (51% v/s 33%), and DM OGTT (30% v/s 20%) were found also in higher frequency in CHC than in cases with CHB (р<0.001). In the both type hepatitis insulin resistance was associated with disease activity. In CHC, but not in CHB, a positive correlation between the degree of steatosis and the activity score was found (r = 0.322, p<0.05). In 70% of the cases with CHB and severe steatosis (>66%) HBV DNA was negative or <10 000 copies/ml. The advanced liver fibrosis (F3-F4) was associated with moderate or severe steatosis (CHC), as well as with the glucose levels, markers of insulin resistance, and presence of DM (p<0.001), but not with the other components of metabolic syndrome.In conclusion, nonalcoholic metabolic related steatosis, diabetes mellitus and insulin resistance are associated with the both viral hepatitis, but the prevalence is higher in chronic hepatitis C. The degree of steatosis correlates with the activity grade and stage of fibrosis only in patients with chronic hepatitis C. Insulin resistance and diabetes mellitus are associated with more advanced liver fibrosis in the both viral hepatiti